Does your health plan cover facility fees for outpatient services provided in hospital-owned physician practices? Private physician offices can't charge these fees, but hospital-owned physician practices are able to charge for facility use. As this article explains, these charges can cost your health plan and/or your employees significant dollars. Several issues are important: Knowing there is a facility charge and the amount of that charge; knowing whether your plan covers it or your employee will have to pay for it as an "uncovered" cost. Many people are being caught completely off guard when these fees show up on their bill. Knowing that there is a charge and what it is, is certainly the first step that is needed.
Finally, since private physicians cannot pass along a facility fee, should you consider "incenting" your employees to use private physicians? Share your ideas with MBGH so we can see what your thoughts are on this issue.
Click here for the Washington Post article.